Vascular loop trigeminal neuralgia Radiology

Trigeminal neuralgia Radiology Reference Article

  1. al neuralgia or tic douloureux corresponds to a clinical manifestation of sudden severe paroxysms of excruciating pain on one side of the face which usually lasts a few seconds to a few
  2. al neuralgia (TN) is characterized by recurrent episodes of intense lancinating pain localized to the sensory supply areas of the trige
  3. al Neuralgia. The most common cause of trige

Trigeminal Neuralgia due to Neurovascular Compression

  1. al neuralgia. Axial CISS images (a, b), axial time-of-flight MRA source images (c, d), and coronal reconstruction (e, f) show AICA loop (yellow arrow) crossing inferomedial to the left trige
  2. al neuralgia (TN) is a debilitating disorder that presents with a sudden onset of severe, unilateral, paroxysmal, and lancinating pain in one or more of the distributions of the trige
  3. al neuralgia is a debilitating facial pain disorder, frequently caused by vascular compression of the trige
  4. al neuralgia An adult with left trige

Imaging of Neurovascular Compression Syndromes: Trigeminal

vascular loop in the anterior inferior cerebellar artery (AICA), insinuating itself into the internal auditory meatus. The term vascular compression syndrome, which refers to a group of diseases caused by direct contact between a blood vessel and a cranial nerve, was introduced b Trigeminal neuralgia (TN) is a neuropathic pain condition characterized by paroxysms of severe, lancinating, electric-shock like pain in one or more of the distributions of the trigeminal nerve. TN is divided into primary (classic) or secondary (symptomatic) one according to its etiology Vascular loop syndrome A 55 yo male with right side trigeminal neuralgia as episodic lancinating pain. MRI 3D FIESTA axial images at the level of posterior fossa show tortuous vertebro basilar causing compression over right side trigeminal nerve. Vascular loop syndrome - 5th CN compression, Trigeminal Neuralgia

Symptomatic trigeminal neuralgia is caused by trigeminal nerve compression by tumors or vascular disorders as malformations or aneurysms or demyelination caused by multiple sclerosis

Radiographic findings in 68 patients with trigeminal neuralgia and 24 hemifacial spasm are reviewed. The relative value of various radiographic diagnostic procedures is discussed. Trigeminal neuralgia and hemifacial spasm are usually caused by vascular compression of the trigeminal root entry zone and facial nerve exit zone respectively of the trigeminal nucleus in the brain stem. Extra-axial mass lesions compressing the trigeminal nerve were detected in four patients. Conclusion: MRI can yield high accuracy in the evaluation and appropriate treatment of patients with TGN. Key words: Trigeminal neuralgia, MRI, vascular loops, neuropathy, trigeminal nerve. Original research articl ofwas compressedcompressionbyIn loop and development trigeminalconfirmed by MRI. The neuralgia dimensions hypertension of structuresWe considered secondary were precipitatedto hypertensionprobablyhistory of neuralgia attacks during unstable bloodmay support our hypothesis. neurovascular compression. In in hypertension together, hypertension are over age of 50. TN is age possibledetermining ataethiologic the same the age of 50Therefore hypertension be take

Tinnitus, sensory neural hearing loss (SNHL), and vertigo are common audio-vestibular symptoms. Many diseases are associated with these symptoms; however, the exact cause is not always identified. Some studies show that the etiology could be related to the presence of a vascular loop in contact with the 8th cranial nerve. Three-dimensional (3D) constructive interference in steady state (CISS. In a posterior fossa craniectomy, a small pad can be placed to separate the pulsating vascular loop from the trigeminal root (called microvascular decompression, or the Jannetta procedure). In gamma knife radiosurgery, gamma radiation is focused on the proximal trigeminal nerve where it exits the brain stem; this procedure interrupts pain. Another treatment option for vascular loop compression trigeminal neuralgia is gamma knife radiosurgery, a noninvasive stereotactic radiosurgical technique that utilizes a focused beam of radiation to target the root of the trigeminal nerve. This option may be preferred in elderly patients because of the lower complication rate . Other. MRI can detect the vascular loops compressing the cranial nerves (fifth, seventh, ninth, eighth, and fourth) and can also rule out secondary causes. The aim of this chapter is to outline the clinical features and pathogenesis of neurovascular syndromes and give an overview of neuroimaging techniques and findings

Vascular Loop Syndrome. Vascular loop syndrome refers to the compression of a nerve root by a vascular loop and can most commonly affects the trigeminal and facial nerves. In the case of the trigeminal nerve, patients may present with trigeminal neuralgia as the result of the contact. High-resolution, heavily T2-weighted images are used to. Compression of the nerve isn't always visible on imaging, but William's MRI showed a large arterial loop compressing his left trigeminal nerve. On June 15, 2010, William underwent MVD. Surgery Successful. Through a small opening behind the ear, Dr. Bederson exposed the trigeminal nerve at its entrance into the brain stem On high-resolution T2W imaging, a vascular loop is often evident compressing the trigeminal nerve. Even if a high-resolution MRI does not identify an offending vascular loop, the consideration for a posterior fossa exploration is appropriate if the patient's pain is consistent with typical trigeminal neuralgia Vascular loop trigeminal neuralgia A 71-year-old female asked: Been recently diagnosed with trigeminal neuralgia, can be extremely painful. at first told could be combining from a vascular or cervical spine issue. im not sure the right referrals or tests were ordered. when it first happened thought it stroke Of the eight patients with a positive finding of arterial conflict, a vascular loop was identified intra-operatively in five patients (62.5%); in two (25.0%) a small granuloma filled with Teflon fibers was found compressed the trigeminal nerve; and in one patient (12.5%) only dense arachnoid adhesions were found around the trigeminal nerve

Single- and double-vessel conflict were observed in 173 and 50 patients, respectively. The compressing vessel was placed anterior to the trigeminal nerve in 39 patients. An arterial loop was in contact with the nerve, producing grooving, and displacing the nerve in 215, 35, and 21 patients, respectively Vascular loop refers to the bend or coil of the anterior inferior cerebellar artery (AICA) in the cerebellopontine angle (CPA) or the internal auditory canal (IAC) that occurs in close proximity to the vestibulocochlear nerve. It is thought to be related to unilateral symptoms of tinnitus, vertigo, and sensorineural hearing loss, but its true clinical significance remains controversial Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Trigeminal Neuralgia The etiological basis of trigeminal neuralgia (TN) is unknown but vascular (arterial and venous) compression of the trigeminal nerve roots has emerged as the likely cause in most cases Dandy WE. Concerning the cause of trigeminal neuralgia. N + 4VSH 1934; 24:447-455. was noted, effected by a vascular loop of the anterior inferior 2. Janetta PJ. Microsurgical approach to the trigeminal nerve for tic douloureux. cerebellar artery

Vascular Loop Syndromes Radiology Ke

  1. al nerve at the root entry zone (REZ) was deter
  2. al neuralgia was first suggested by Dandy et al. in 1934. [2] The same concept was expanded to explain various cranial nerves disorders including hemifacial spasms, glossopharyngeal neuralgia, and geniculate neuralgia. Janetta was the first to perform microvascular.
  3. Vascular loops from cranial on the nerve were the most frequent types of compression in all areas of pain, followed by mediocranial loops. This evaluation is reproducible and contributes to the role of magnetic resonance imaging and a classification of findings in the preoperative evaluation of NVC

MRI of the Trigeminal Nerve in Patients With Trigeminal

Vascular impingement of the trigeminal, facial, and vestibulocochlear nerves has been associated with several clinical conditions such as trigeminal neuralgia, hemifacial spasm (HFS), and benign paroxysmal vertigo, respectively. However, vessels related to these cranial nerves are frequently incidentally noted intra-operativel Vascular compression at the trigeminal nerve (TN) root entry zone in the cerebellopotine angle (CPA) is the most common cause of trigeminal neuralgia.[8 15 22] The presence and severity degree of vascular compression found during the surgery has been correlated with a remarkable improvement after microvascular decompression (MVD).[4 21 26 29] For this reason, a precise preoperative evaluation. D-G, operative views: D, the SCA compresses (Grade 3) the left trigeminal nerve (T) at its superior and medial aspects of the root entry zone; E, the vascular loop of SCA was gently dislocated from the nerve (T); F, the indentation caused by vascular loop of SCA (LSCA) is quite visible (black arrows); G, the LSCA is maintained apart from the nerve

Neurovascular compression of trigeminal nerve | The ThirdVestibular paroxysmia, vascular loop syndrome

8th cranial nerve was detected after microvascular de-compression, which favored relation to the existence of a vascular loop [2, 9]. Though the concept of vascular compression has been adopted for hemifacial spasm and trigeminal neuralgia, contradictory results have been re-ported about the relationship between VCS and neuro Radiology 166: 875 - 882, 1988 Lenz WG Wong BY, , Steinberg GK, & Rosen L: Magnetic resonance imaging of vascular compression in trigeminal neuralgia. Case report. J Neurosurg 70: 132. nal nerve. The pain was triggered by tactile stimuli such as chewing or brushing the teeth. Cranial MRI was repeated and a second aberrant vascular loop compressing the left trigeminal nerve entry zone was noticed (Fig. 1B). In addi-tion to botulinum toxin injections similar to previous injec-tions, he was also treated with carbamazepine 400 mg/da Trigeminal neuralgia in children is very rare. It was first described in a 10-year-old boy in 1921 [], but only a few case reports have been published.In terms of pathogenesis, it is generally accepted that the trigeminal nerve is directly affected by a vascular loop [] as a result of atherosclerotic changes.However, in recent studies a smaller volume of the pontomesencephalic cistern [] and a. Microvascular decompression can be used to effectively treat vascular loop syndromes, such as trigeminal neuralgia and glossopharyngeal neuralgia (Figs. 12.19, 12.20, and 12.21). The technique essentially consists of interposing Teflon between the affected nerve and the offending vessel

Trigeminal Neuralgia-MRA - Sumer's Radiology Blo

Vascular loops in the anterior inferior cerebellar artery

Pulsatile tinnitus is generally of vascular origin and can be due to arterial, venous, or systemic causes. While certain congenital anatomical variants and arterial vascular loops have been commonly found in symptomatic patients undergoing imaging, persistent primitive trigeminal artery in association with isolated tinnitus is unusual. Thus we report a patient with unilateral isolated. Vascular loop syndrome. Abnormal anatomical variation or course of vessel causing symptomatic compression over cranial nerves at IAC or Cp Angle cistern. Spasmodic hyperfunction of nerve due to compression. Compression of 5th CN (Trigeminal nerve) present with trigeminal neuralgia and 7th CN (Facial nerve) present with hemi facial spasm The exact cause of trigeminal neuralgia remains unknown. The majority of cases are referred to as idiopathic, although many are associated with vascular compression of the trigeminal nerve close to its exit from the brainstem by an aberrant loop of an artery or vein In patients with trigeminal neuralgia (TN), routine head imaging identifies structural causes in up to 15% of patients and may be considered useful (Level C). Trigeminal sensory deficits.

Trigeminal Neuralgia in a Patient with Vascular Loop

Skip to main content. MENU. Searc The concept of vascular compression syndromes was popularized by Jannetta , who reported a reduction in dysfunctional hyperactivity of the eighth cranial nerve after using microsurgery to separate the nerve from a blood vessel, supporting the theory that a vascular loop is an etiological factor of dysfunction Trigeminal neuralgia (TN), also called tic douloureux, is a chronic pain condition that affects the trigeminal or 5th cranial nerve, one of the most widely distributed nerves in the head. TN is a form of neuropathic pain (pain associated with nerve injury or nerve lesion.) The typical or classic form of the disorder (called Type 1 or TN1.

Trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia, tinnitus, and vertigo are examples of the neurovascular compression syndrome . The purpose of the study was to assess the relationship between the vascular loop in cerebellopontine angle and the otological symptoms Compression: 80% to 90% of patients have demonstrable focal compression of the trigeminal nerve root at the root entry zone by an aberrant vascular loop (typically the superior cerebellar artery). Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis DOI: 10.2214/AJR.14.14156 Corpus ID: 31514041. MRI of the Trigeminal Nerve in Patients With Trigeminal Neuralgia Secondary to Vascular Compression. @article{Hughes2016MRIOT, title={MRI of the Trigeminal Nerve in Patients With Trigeminal Neuralgia Secondary to Vascular Compression.}, author={M. Hughes and A. Frederickson and B. Branstetter and X. Zhu and R. Sekula}, journal={AJR Trigeminal Neuralgia or Tic Douloureux is the condition where patients experience severe pain along one or more divisions of the Trigeminal Nerve (V nerve). This is not an uncommon disorder but patients often present after multiple consultations for dental disorders or Herpetic Neuralgia or even Migraine

Dr Balaji Anvekar FRCR: Vascular loop syndrom

Trigeminal pain: Potential role of MRI - ScienceDirec

Presence of vascular loop in patients with audio

17 Microvascular Decompression for Hemifacial Spasm and Trigeminal Neuralgia Tetsuo Kanno and Iyer Viswanathan The microvascular decompression of cranial nerves has become an accepted surgical technique for the treatment of trigeminal neuralgia, hemifacial spasm (HFS), glossopharyngeal neuralgia, and other cranial nerve neuropathies. It is a surgery that requires sound anatomic knowledge and. 19 years experience Interventional Radiology. Trigeminal neuralgia: The context of your question is unfortunately not completely clear but i will give it my best - trigeminal neuralgia Vascular loop trigeminal neuralgia. Mri of trigeminal neuralgia. Connect by text or video with a U.S. board-certified doctor now — wait time is less than 1. Additional causes of trigeminal neuralgia include anuersysms, AVMs, and tumors of the cerebello-pontine angle. Demyelinating disorders such as multiple sclerosis are also described as a potential cause. Thin section high resolution T2 MRI of the CPA/IAC allows the best visualization of the vascular loop Vascular compression of the trigeminal nerve root may contribute to trigeminal neuralgia even in patients with demyelinating disorders; compression of the root entry zone by a blood vessel has been demonstrated in a sizeable minority of patients with multiple sclerosis and trigeminal neuralgia (Meaney et al., 1995a, b; Crooks and Miles, 1996.

Trigeminal Neuralgia - Neurologic Disorders - Merck

Pediatric (Body, MSK and Chest) Pediatric imaging protocols currently applied in our MRI section. Radiologists work closely with OHSU MRI techs in the art of creating optimal images from current technology. Dr. Petra Vajtai has approved the protocols below. The pediatric radiologists will usually protocol specific sequences they need in RIS Textbook of Trigeminal Neuralgia. Trigeminal neuralgia (TN) is a condition that can cause intense facial pain sometimes so severe it can interfere with the normal activities of daily living. Brief, painful episodes may be triggered by chewing, talking, smiling, brushing teeth, shaving, or light pressure on the face Percutaneous procedures to treat trigeminal neuralgia include: glycerol injections - where a medicine called glycerol is injected around the Gasserian ganglion, where the 3 main branches of the trigeminal nerve join together. radiofrequency lesioning - where a needle is used to apply heat directly to the Gasserian ganglion Trigeminal neuralgia (TN) can be described as a chronic, debilitating condition resulting in intense and extreme episodes of pain in the face. The episodes are sporadic and sudden and often like 'electric shocks', lasting from a few seconds to several minutes. TN results from a neuropathic disorder of the Vth cranial nerve (trigeminal nerve) Compression: 80% to 90% of patients have demonstrable focal compression of the trigeminal nerve root at the root entry zone by an aberrant vascular loop (typically the superior cerebellar artery). Reports of trigeminal nerve compression by true vascular malformations (aneurysms or arteriovenous malformations) exist but are rare

Classical trigeminal neuralgia (TN) is a facial pain disorder caused by distinct vascular compression of the trigeminal nerve mostly at the root entry zone [1,2,3,4].The vascular compression caused by arterial or venous loops might induce focal demyelination at the transition between central and peripheral myelin sheath, which can lead to ectopic impulses and ep-haptic transmission, so that. To know the significance of trigger point as an indicator of aberrant vascular loop in patients with trigeminal neuralgia. This study was performed in the department of neurosurgery Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from May 2003 to April 2006. Patients with clinica rate of pain recurrence. Most cases of trigeminal neuralgia are caused by neurovascular compression. However, contact between the trigeminal nerve and vessels has been reported in asymptomatic cadavers. Advances in MRI have made it possible to demonstrate accurately the relationship between the trigeminal nerve and surrounding vessels

Neurovascular Relations of the Trigeminal Nerve in

Trigeminal neuralgia associated with a variant of

glossopharyngeal neuralgia, and some cases of disabling vertigo and tinnitus. Materials and methods Between 1994 and 2008, MRI radiographs of 782 cases of vasculoneural compression were reviewed to analyze the imaging criteria of the offending vascular loop and were correlated with intraoperative vascular decompression findings i An acoustic neuroma is a benign, small, slow-growing tumor on the VIII cranial nerve-technically called a vestibular schwannoma. The MRI found no evidence of a tumor but surprisingly identified a vascular loop occupying some of the space reserved for the VIII nerve to emerge from the inner ear and enter the brain Diagnostic cerebral angiography confirmed the presence of a Spetzler-Martin grade II 2-cm AVM 1 supplied by branches of the AICA and posterior inferior cerebellar artery (PICA) with both superficial and deep venous drainage (Figure 2).The trigeminal neuralgia symptoms were therefore thought to be associated with compression of the trigeminal nerve by an ectatic loop of AICA Keywords Meckel'scave.Trigeminal .Neuralgia .Perineural .Skullbase Introduction Meckel's cave is a natural mouth-shaped aperture in the me-dial portion of the middle cranial fossa that acts as a key conduit for the largest cranial nerve, the trigeminal nerve (CN V). It connects the cavernous sinus to the prepontine cistern of the posterior. The patient was relieved of the neuralgia immediately after surgery without further neurological deficit. He has been free of trigeminal neuralgia during a follow-up period of 2 years and is scheduled to undergo stereotactic radiosurgery for the treatment of the AVM. CONCLUSION: Intrinsic AVM of the trigeminal nerve may cause trigeminal neuralgia

Compression of the trigeminal nerve results in trigeminal neuralgia, or nerve pain of the forehead, cheek, jaw, or eye. It is often described as stabbing or shocking pain. It may be triggered by light touch or a gust of wind on the face. Talking, chewing, shaving, etc have also been described as triggers. The facial nerve is the seventh cranial. OBJECTIVE Trigeminal neuralgia is a debilitating facial pain disorder, frequently caused by vascular compression of the trigeminal nerve. Vascular compression that results in trigeminal neuralgia occurs along the cisternal segment of the nerve. CONCLUSION Imaging combined with clinical information is critical to correctly identify patients who are candidates for microvascular decompression trigeminal and the proatlantal intersegmental artery. Failure of regression of one or more of these primitive anastomoses leads to persistent carotid-vertebrobasilar anastomoses, of which persistent primitive trigeminal artery is the most common type [ ]. e overall incidence of persistent primitive trigeminal An intimate relationship between trigeminal neuralgia (TN) and short‐lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome, based on similar clin..

Meckel's cave is a dural recess in the posteromedial portion of the middle cranial fossa that acts as a conduit for the trigeminal nerve between the prepontine cistern and the cavernous sinus, and houses the Gasserian ganglion and proximal rootlets of the trigeminal nerve. It serves as a major pathway in perineural spread of pathologies such as head and neck neoplasms, automatically. A pulsatile vascular structure was found compressing the right C-4 nerve root. The bone overlying the vascular structure was removed, producing decompression of the nerve root. Immediate postoperative angiography showed that this lesion was a focal vertebral artery loop Several surgical approaches used to relieve the pain due to TN include neurectomy of trigeminal nerve branches outside the skull, percutaneous radiofrequency thermal rhizotomy, percutaneous ablation that creates trigeminal nerve or trigeminal ganglion lesions with heat [80-82], percutaneous retrogasserian glycerol rhizotomy, injection of. trigeminal nerve starting from its origin in the brain stem till the cavernous parts was scanned and examined. The cisternal portion was examined with special attention for the presence of any vascular loop or neurovascular conflicts and any secondary change in trigeminal nerve was looked for Therefore, both sectioning the dorsal roots of C2 and microvascular decompression of the PICA loop were performed. Postoperatively, the patient experienced complete cure of her neuralgia. Vascular compression as a cause of refractory occipital neuralgia should be considered when assessing surgical options

Compression of CN V root from tumor (meningioma) or aberrant vascular loop (SCA), or demyelination from MS or an anamolous vascular loop True or False: Trigeminal neuralgia can have a connection with MS Trigeminal neuralgia (TN), or tic douloureux, is a severe, shock-like neuropathic pain resulting in sudden — usually unilateral — short, stabbing, recurrent pain in the distribution of one or more branches of the trigeminal nerve, often set off by light stimuli (such as touch or movement) in a trigger zone. 1,2 It typically presents with piercing pain along the nerve path, which may last. Vascular loop compressing the trigeminal nerve root entry zone can be seen on a high resolution MRI of the posterior cranial fossa. Loss of sensation is uncommon in trigeminal neuralgia. Diagnostic tests are also useful in determination of the cause of trigeminal neuralgia- like pain, when the symptoms are not very typical

Facial pain syndrome in the distribution of ≥1 divisions of the trigeminal nerve. Diagnosis is clinical, with a history of paroxysms of sharp, stabbing, intense pain lasting up to 2 minutes. First-line therapy is medical, to which the majority of patients are partially responsive. Surgical/ablati.. On the basis of that study, various other researchers have attempted to establish a relationship between vascular compressions and a number of clinical conditions, such as hemifacial spasm and trigeminal neuralgia (4 4 Markowski J, Gierek T, Kluczewska E, et al. Assessment of vestibulocochlear organ function in patients meeting radiologic. Introduction. Trigeminal neuralgia (TN), also known as tic doloureaux [1,2], is considered to be one of the most physically and psychologically painful conditions a human being might suffer [1,2].Living with TN can have a significant negative impact on a person's quality of life [], resulting in problems such as seclusion, weight loss and depression [3,4]

Trigeminal Neuralgia-MRA - Sumer's Radiology BlogDr Balaji Anvekar FRCR: Cranial Nerves MRI Planning Protocol

According to the international headache society (IHS), trigeminal neuralgia (TN) is a disorder characterized by recurrent unilateral brief, shock-like pain abrupt in onset and termination, limited to the distribution of one or more divisions of the trigeminal nerve. Peak incidence is between the ages of 50 and 60 years, more common in women Trigeminal Neuralgia is characterized by severe, sharp lancinating pain in one or more of the divisions of the nerve. This pain maybe paroxysmal - occurring suddenly without provocation or during any activity such as brushing or chewing or even on exposure to a breeze to the face. In some patients the pain is continuous and debilitating Gorrie et al (2010) substantively added to the literature with their new article regarding vascular loops (VLs) and microvascular compression (MVC) as a cause of unexplained unilateral auditory symptoms. Since the 1970s, the pioneering work of Jannetta (with regard to VLs impinging upon cranial nerves) has potentially explained hemi-facial spasm, trigeminal neuralgia

An initial brain magnetic resonance imaging (MRI) revealed a suspicious culprit of a vein loop which was confliction at the root-en-try-zone of trigeminal nerve without any abnormal structures. Axial thin-sliced T2 image (A), enlarged view of trigeminal nerve and its sus-picious culprit in red box of A (B). A B Fig. 2 Thin vascular loop of SCA abutting cranial aspect of the right trigeminal nerve at the root entry zone is noted. Contorted faces of men suffering from agonizing facial pain have been recorded. Microvascular decompression (MVD), also known as the Jannetta procedure, is a neurosurgical procedure used to treat trigeminal neuralgia (along with other cranial nerve neuralgias) a pain syndrome characterized by severe episodes of intense facial pain, and hemifacial spasm.The procedure is also used experimentally to treat tinnitus and vertigo caused by vascular compression on the. Vascular Loop..The superior cerebellar arteries crossover the superior aspects of the cisternal segments of the trigeminal nerves bilaterally with possible mild indention Cavernous sinus and Meckels cave..normal.no masses internal auditory canals..unremarkable Brainstem and cerebellar.normal no mass acute infarct , or demyelinating lesion

Cluster-like headache secondary to trigeminal meningioma

In classical TN, MRI findings may show distortion or atrophy of the trigeminal nerve due to vascular compression by a tortuous artery or arterial loop. Intracranial masses, multiple sclerosis plaques, or other abnormalities causing secondary trigeminal neuralgia may also be found with MRI imaging Atypical Trigeminal Neuralgia. Atypical trigeminal neuralgia is also known as type 2 trigeminal neuralgia. The person experiences constant aching, burning and stabbing pain of low intensity (compared to Type 1). This type of pain is difficult to diagnose. It is a rare condition, and the symptoms overlap with several other disorders Objective: The current opinion among neurosurgeons regarding the selection between microvascular decompression (MVD) and gamma knife radiosurgery for trigeminal neuralgia is not based on clear evidence. In this meta-analysis, we have attempted to synthesize the findings of the prospective trials comparing the efficacy and complications of the two procedures as primary treatment modality for.